Patient Radiation Dose Reporting (P-RDSR) Supplement is developed - PowerPoint PPT Presentation

Supplement 191: Patient Radiation Dose Reporting (P-RDSR) Supplement is developed by DICOM Working Group 28 (WG-28-Physics)

Patient Radiation Dose SR (P-RDSR) • Current Radiation Dose SR contains only information about the x-ray system or information the x-ray system can determine, e.g.: • radiation output, geometry, x-ray source, detector system, etc. • Estimation of patient/organ dose requires knowledge of: – Radiation beam characteristics – Models of the patient/organs – Models of radiation interaction within the patient • Methods to do patient dose estimations are being developed and improved continuously – storage of these estimations in a different object would allow more versatile utilization of the data 15 Sept 2016 DICOM WG-28 / Supp 191 2

Patient Radiation Dose SR (P-RDSR) • Goals of the Patient Dose SR – Store the results of Patient Organ Dose calculations: – of a SINGLE procedure or MULTIPLE procedures – including one or more modalities and procedure steps/phases – of one or more organs – by one or more calculation methods – Exchange intermediate results with peers • Examples of modalities and procedures: Single modality, single procedure step Multi-modality, single procedure step • CT • SPECT and PET/CT – – internal organ dose internal organ dose – eye dose Single modality, multi-procedure step • XA/RF (one time point) • CT – – skin dose map internal organ dose – – internal organ dose eye dose • Mammography • XA/RF (multi time points being combined) – – glandular dose skin dose map • Projection x-ray (CR/DX) • XA localization / disgnostic plus intervention – – entrance skin dose skin dose map – – internal organ dose internal organ dose • NM/PET • Mammography/Projection X-ray – – internal organ dose Tomosynthesis 15 Sept 2016 DICOM WG-28 / Supp 191 3 3

Patient Radiation Dose SR (P-RDSR) Data flow – simple case Calculation Radiation Patient Organ 1 Dose SR 1 Dose SR 1 Method 1 Dose Estimate #1 : • Organ 1 • RDSR Source 1 • Method 1 15 Sept 2016 DICOM WG-28 / Supp 191 4 4

Patient Radiation Dose SR (P-RDSR) One RDSR, multiple organs Calculation Radiation Patient Organ 1 Dose SR 1 Dose SR 1 Method 1 Dose Estimate #1 : • Organs 1, 2, 3 • RDSR Source 1 • Method 1 Organ 2 Organ 3 15 Sept 2016 DICOM WG-28 / Supp 191 5

Patient Radiation Dose SR (P-RDSR) Multiple RDSRs, multiple organs Calculation Radiation Patient Organ 1 Dose SR 1 Dose SR 1 Method 1 Dose Estimate #1 : • Organs 1, 2, 3 • RDSR Source 1 • Method 1 Dose Estimate #2 : • Organs 1, 2, 3 • RDSR Source 2 Radiation Organ 2 • Method 1 Dose SR 2 Or combining RDSRs: Dose Estimate #3 • Organs 1, 2, 3 • RDSR Sources 1, 2 • Method 1 Organ 3 15 Sept 2016 DICOM WG-28 / Supp 191 6

Patient Radiation Dose SR (P-RDSR) Multiple RDSRs, multiple organs, multiple methods Calculation Radiation Patient Organ 1 Dose SR 1 Dose SR 1 Method 1 Dose Estimate #1 : • Organs 1, 2, 3 • RDSR Source 1 • Method 1 Dose Estimate #2 : • Organs 1, 2 Calculation • RDSR Source 2 Radiation Organ 2 • Method 1 Method 2 Dose SR 2 Dose Estimate #3 : • Organs 1, 2 • RDSR Source 1 • Method 2 Dose Estimate #4 : • Organs 1, 2 • RDSR Source 2 • Method 2 Organ 3 Or combining RDSRs: Dose Estimate #5 : • Organs 1, 2, 3 • RDSR Sources 1, 2 • Method 1 Dose Estimate #6 : • Organs 1, 2 • RDSR Sources 1, 2 • Method 2 15 Sept 2016 DICOM WG-28 / Supp 191 7

Patient Radiation Dose SR (P-RDSR) Patient Dose Determination: Data Flow Requirements Modality Frame of Reference (FOR) Modality Image Radiation Dose SR Radiation Exposure Information - X-Ray exposure techniques X-Ray - Table, Gantry Angle, Beam Geometry, collimation Equipment - Dose measure: CTDI, DAP, ... Organ Dose Reporter System Signifies part of Supplement 191 Patient RDSR 15 Sept 2016 DICOM WG-28 / Supp 191 8

Patient Radiation Dose SR (P-RDSR) Patient Dose Determination: Data Flow Requirements Modality Frame of Reference (FOR) Modality Image Radiation Dose SR Radiation Exposure Information - X-Ray exposure techniques X-Ray - Table, Gantry Angle, Beam Geometry, collimation Equipment - Dose measure: CTDI, DAP, ... Organ Dose Reporter System Equipment Information Patient Patient Model - Table dimension Model FOR Attenuating material, … - Registration IOD Patient Registration Information - Patient position on table - Fiducials - Registration matrix between Patient FOR and Equipment FOR Signifies part of Supplement 191 Patient RDSR 15 Sept 2016 DICOM WG-28 / Supp 191 9

Patient Radiation Dose SR (P-RDSR) Patient Dose Determination: Data Flow Requirements Modality Frame of Reference (FOR) Modality Image Radiation Dose SR Radiation Exposure Information - X-Ray exposure techniques X-Ray Patient Dose Surface - Table, Gantry Angle, Beam Geometry, collimation Equipment 3D map/view - Dose measure: CTDI, DAP, ... Organ Dose Reporter System Equipment Information Patient Patient Model - Table dimension Model Patient Dose 2D FOR Attenuating material, … - view/map (e.g. iso- dose map) Patient Registration Dose SR IOD Patient Registration Information Calculated data for - Patient position on table documentation and - Fiducials reference to images and - Registration matrix between Patient RDSR’s FOR and Equipment FOR Signifies part of Supplement 191 Patient RDSR 15 Sept 2016 DICOM WG-28 / Supp 191 10

Patient Radiation Dose SR (P-RDSR) Registration between Patient Model and RDSR Case #1 Patient Images FOR X-Ray Images       A B M M M T x x X-Ray Equipment Radiation Dose SR (RDSR) 11 12 13 x       A B - Table, position M M M T  y   y     21 22 23 y - Gantry Angle       Registration A B M M M T z z      31 32 33 z  - Beam Geometry, collimation           1 0 0 0 1 1 Registration matrix between: - each RDSR FOR and - the Patient Model FOR Patient Model FOR Patient Model (3D image) 15 Sept 2016 DICOM WG-28 / Supp 191 11

Patient Radiation Dose SR (P-RDSR) Registration between Patient Model and RDSR Case #2 FOR TABLE TOP HEAD Equipment Fiducials       A B M M M T x x X-Ray Equipment Radiation Dose SR (RDSR) 11 12 13 x       A B - Table position vs. Isocenter M M M T  y   y     21 22 23 y - Gantry Angle vs. Isocenter       Registration A B M M M T z z      31 32 33 z  - Beam Geometry, collimation           1 0 0 0 1 1 Registration matrix between: - each RDSR Fiducial FOR and - the Patient Model FOR Patient Model FOR Patient Model (3D image) 15 Sept 2016 DICOM WG-28 / Supp 191 12

Patient Radiation Dose SR (P-RDSR) Registration between Patient Model and RDSR Case #3 FOR TABLE TOP HEAD Equipment Fiducials       A B M M M T x x X-Ray Equipment Radiation Dose SR (RDSR) 11 12 13 x       A B - Table position vs. Isocenter M M M T  y   y     21 22 23 y - Gantry Angle vs. Isocenter       Registration A B M M M T z z      31 32 33 z  - Beam Geometry, collimation           1 0 0 0 1 1 FOR Registration matrix between: PATIENT TOP HEAD - each RDSR Fiducial FOR and - the Patient Fiducial FOR Patient Fiducials Note: the patient fiducials can be defined through a manual measurent on the actual patient landmarks, or through image- based measurements of landmarks visible on the X-Ray images. 15 Sept 2016 DICOM WG-28 / Supp 191 13

Patient Radiation Dose SR (P-RDSR) Registration between Patient Model and RDSR Case #4 No X-Ray Images No Equipment Fiducials X-Ray Equipment Radiation Dose SR (RDSR) - Table position vs. Isocenter Free Text Comment: - Gantry Angle vs. Isocenter Registration E.g. “ Distance from Patient Head - Beam Geometry, collimation to Table Top Head is 15 cm ” No Patient Model 15 Sept 2016 DICOM WG-28 / Supp 191 14

Patient Radiation Dose SR (P-RDSR) Patient Dose SR IOD Templates TID 1002 Observer TID prdsrT01 Patient Context Radiation Dose TID 1204 Language of Content Item and Descendants TID prdsrT02 Dose TID prdsrT04 Dose Estimate Estimate Methodology TID prdsrT05 Dose Estimate Parameters TID prdsrT03 Dose Estimate Representation 15 Sept 2016 DICOM WG-28 / Supp 191 15